Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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비만 아동에서 leptin, adiponectin 및 resistin의 혈중농도와 인슐린 저항성과의 관계

Serum leptin, adiponectin and resistin levels in obese children and their correlations with insulin resistance

  • 박민영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 안선아 (가톨릭대학교 의과대학 소아과학교실) ;
  • 조원경 (가톨릭대학교 의과대학 소아과학교실) ;
  • 조경순 (가톨릭대학교 의과대학 소아과학교실) ;
  • 박소현 (가톨릭대학교 의과대학 소아과학교실) ;
  • 한승훈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정민호 (가톨릭대학교 의과대학 소아과학교실) ;
  • 서병규 (가톨릭대학교 의과대학 소아과학교실)
  • Park, Min Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Ahn, Sun A (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Cho, Won Kyoung (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Cho, Kyoung Soon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Park, So Hyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Hahn, Seung Hoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Jung, Min Ho (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Suh, Byung Kyu (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2009.02.05
  • 심사 : 2009.04.30
  • 발행 : 2009.07.15
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초록

목 적 : 대사증후군은 심혈관계질환과 고지혈증, 비만, 당뇨병 등의 증상을 나타내는 증후군으로 최근 소아청소년 연령에서 유병률이 증가하고 있다. 대사증후군을 일으키는 주된 병태생리는 인슐린 저항성이다. 최근에 와서 체내의 지방조직은 혈중에 여러 아디포사이토카인들을 분비하여 인슐린 감수성을 조절한다고 알려졌다. 저자들은 비만 아동의 혈중 렙틴, 아디포넥틴 및 레지스틴등의 혈중 농도를 측정하여 정상 아동과 비교하였으며 이들 사이토카인들과 인슐린 저항성과의 상관관계도 알아보고자 하였다. 방 법 : 비만아 36명(남 17명, 여 19명)의 평균연령은 $9.3{\pm}1.9$세였고 평균 체질량지수(BMI)는 $23.2{\pm}2.6kg/m^2$ 였다. 정상대조군 35명(남 16명, 여 19명)의 평균연령은 $9.1{\pm}2.1$세였으며 평균 체질량 지수는 $16.8{\pm}1.4kg/m^2$ 였다. 결 과 : 비만군에서 정상대조군보다 체중, 신장 및 BMI가 유의하게 차이가 있었으며 공복혈당, 인슐린 농도가 높았으며 인슐린 저항성의 지표인 HOMA-IR도 유의하게 높았다. 또 비만군에서 혈중 렙틴농도가 유의하게 높았고(P<0.001) 아디포텍틴은 유의하게 낮았다(P<0.001). 혈중 레지스틴은 두 군간에 차이가 없었다. 렙틴/아디포넥틴 비는 비만군에서 유의하게 높았다(P<0.001). 또 비만군에서 HOMA-IR은 체중, 신장, BMI및 렙틴과 양의 상관관계가 있었으나 연령, 아디포넥틴, 레지스틴과는 상관이 없었다. 비만군에서 렙틴은 연령, 체중, 신장 및 BMI와 양의 상관관계가 있었으나 아디포넥틴 과 레지스틴은 기타변수와 상관이 없었다. 결 론 : 비만군에서 렙틴/아디포넥틴 비는 인슐린 저항성과 의미있는 연관성이 있어 향후 비만의 예후를 추정하는 변수로 이용될 수 있을 것으로 생각되며 비만군에서 아디포넥틴이 감소되어 있었다는 것은 아디포넥틴이 비만 발생의 억제기전에 중요한 역할을 할 것으로 생각된다.

Purpose : The objective of this study was to compare the levels of adipocytokines in obesity group with those in control group and examine their correlation with insulin resistance. Methods : We enrolled 36 obese children (male:female [M:F]=17:19; age, $9.3{\pm}1.9yrs$) with ${\geq}95^{th}$ percentile body mass indexes (BMIs) (obesity group) and 35 healthy children (M:F=16:19; age, $9.1{\pm}2.1yrs$) with $25^{th}-75^{th}$ percentile BMIs (control group). We measured the serum leptin, adiponectin, and resistin levels and insulin resistance in both the groups. Results : The weights, heights, BMIs, fasting sugar levels, insulin levels, and homeostasis model assessment for insulin resistance (HOMA-IR) values were higher in the obesity group than in the control group. As compared to the control group, the obesity group showed significantly higher leptin levels and lower adiponectin levels; no significant difference was observed in the resistin levels. The leptin/adiponectin (L/A) ratio was higher in the obesity group than in the control group. In the obesity group, HOMA-IR showed significant positive correlations with weight, height, BMI, and leptin level. However, it was not correlated with age and adiponectin and resistin levels. In the obesity group, leptin level showed significant positive correlations with age, weight, height, and BMI, while adiponectin and resistin levels showed no such correlations with the other variables. Conclusion : We suggest that adiponectin plays an important protective role against weight gain in obese children. Further, L/A ratio can be used as a parameter for predicting the prognosis of obese children.

키워드

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